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Individual

MRS. CECILIA A SERNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4330 N PERSHING AVE STE B3, STOCKTON, CA 95207-6965
(209) 476-8533
Mailing address
4330 N PERSHING AVE STE B3, STOCKTON, CA 95207-6965
(209) 476-8533

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A5125098
DRIVER LICENSE
CA
Enumeration date
06/10/2008
Last updated
06/10/2008
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